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Reyvow (Lasmiditan)

Reyvow was approved in October 2019 for adults with migraine, with or without aura. It is the first new acute treatment (also known as abortive or rescue medication) for migraine in more than two decades. Clinical trials showed that when taking Reyvow, people with migraine got symptom relief within two hours of taking the medication. This is promising news, and if you experience migraine, knowing more information about Reyvow can help you make an informed choice about taking it, along with talking with your doctor.

What are the ingredients in Reyvow?

The active ingredient in Reyvow is lasmiditan, with inactive ingredients including croscarmellose sodium, magnesium stearate, pregelatinized starch, microcrystalline cellulose, and sodium lauryl sulfate.1 There are also color mixture ingredients that give the medication its color, and can include black ferric oxide, polyvinyl alcohol, talc, titanium dioxide, red ferric oxide, and polyethylene glycol.1

How does Reyvow work?

The exact ways that Reyvow works aren’t known, but the drug binds to 5-HT1F receptors in the brain.2 It is known as a serotonin 1F receptor agonist, and is the first and only drug approved by the Food and Drug Administration in this class.2

What are the possible side effects of Reyvow?

As with any medication, there is the possibility of adverse side effects when taking this medication. Not everyone will experience every potential side effect, and if the side effects don’t subside, talk with your doctor.

The most common side effects of Reyvow seen in clinical trials include:

  • dizziness
  • fatigue
  • paresthesia (a tingling or pricking of the skin)
  • sedation (feeling drowsy or relaxed)
  • nausea or vomiting
  • muscle weakness1

Less commonly seen side effects included:

  • cognitive changes
  • confusion
  • restlessness
  • sleep disturbance
  • tremor
  • vertigo
  • visual impairment
  • palpitations (feeling like heart is racing or pounding)
  • anxiety.1

Reyvow may cause serotonin syndrome in some people, especially if you are also taking serotonergic drugs like certain antidepressants.1 Symptoms can include:

  • agitation
  • hallucinations
  • rapid heartbeat
  • unstable blood pressure
  • lack of coordination
  • gastrointestinal distress1

If you experience these symptoms, call your doctor and do not take any more Reyvow until you see the doctor.

This medication may also decrease heart rate and increase blood pressure; for those who have cardiovascular conditions, talk with your doctor about whether this is the appropriate drug for your migraine.1 You may need additional testing or monitoring when taking this medication.

Reyvow may interact with other medications you are taking, especially CNS depressants, drugs for heart rate, and certain antidepressants.1 Tell your doctor about all medications and supplements you take before starting Reyvow.

Things to know about Reyvow

Reyvow has been shown to cause significant impairment with driving, and you should not take the drug if you have to or plan to drive within 8 hours of taking the medication.1 If you don’t think this is possible, talk with your doctor about other medications that may treat your migraine.

This medication is not to be used as a preventative treatment for migraine.

Right now, there is no data on the safety of Reyvow for those who are pregnant or breastfeeding. Talk with your doctor about whether you plan to become pregnant or breastfeed while taking Reyvow, and whether it is safe for you to do so. It has not been tested in children and should not be given to kids.

For people over the age of 65, dizziness and changes in blood pressure were more often seen in older populations, and there were not enough people over 65 studied in the clinical trial to get a good picture of how this medication works, compared to younger people. Those older than 65 should talk with their doctor about taking Reyvow, and use caution when taking it and start with a low dose to monitor any adverse effects.1

There is the potential for abuse of Reyvow, since it can cause feelings of intense happiness and hallucinations. Those taking the medication should be monitored and evaluated for signs of misuse and abuse.1

Dosing information

Reyvow comes in two dosages: a 50 mg tablet or 100 mg tablet.1 The recommended dose of Reyvow is 50 mg, 100 mg, or 200 mg, taken orally as prescribed.1 One dose should be taken in 24 hours, and when taking Reyvow, at least 8 hours should pass before taking the drug and either driving or using machinery.1 It can be taken with or without food. Taking it more than four times for migraine within a 30-day period has not been tested for safety.1 Overuse of migraine medications can actually cause exacerbation of headache, and withdrawal from medications might be necessary for relief.1

For more information, read the full prescribing information of Reyvow.

  1. Reyvow Prescribing Information. http://pi.lilly.com/us/reyvow-uspi.pdf 2019. Accessed October 22, 2019.
  2. Lilly’s Reyvow (lasmiditan), The First and Only Medicine in a New Class of Acute Treatment for Migraine, Receives FDA Approval. Lilly. https://investor.lilly.com/news-releases/news-release-details/lillys-reyvowtm-lasmiditan-first-and-only-medicine-new-class Published October 11, 2019. Accessed October 22, 2019.